title: The individual determinants of care-seeking among middle-aged women reporting urinary incontinence: analysis of a 2273-woman cohort.
abstract: OBJECTIVE
  Our main objective was to analyze individual determinants that lead middle-aged women to seek medical care for urinary incontinence (UI).
  
  
  METHODS
  Observational longitudinal study among GAZEL cohort participants: 2,640 women aged 50-62 completed a self-administered questionnaire at baseline. Eight years later (2008) 2,273 (86%) responded to a follow-up questionnaire. Seeking care for UI was defined as any consultation for UI during the 8-year follow-up period. Individual determinants considered in the regression analysis were social and demographic characteristics, social relations, UI type and severity, and other health factors.
  
  
  RESULTS
  Among 1,192 women reporting incontinence at baseline, 24.4% had visited a physician at least once for UI during the follow-up period (56.0% of those reporting severe UI). The care-seeking rate increased with age at baseline. Multivariate analysis showed that women who reported severe UI (OR = 4.1; 95% CI 2.6-6.5), mixed UI (2.0; 1.3-3.0), or neurologic disease (1.6; 1.1-2.6), had weak social support (1.4; 1.0-2.0), or talked about their UI with close friends or family (1.5; 1.0-2.1) were more likely to seek care for UI. A model including these factors had a 78% probability of correctly differentiating women with incontinence who chose to seek care from those who did not. Our analysis could not take factors related to the organization of health services into account.
  
  
  CONCLUSIONS
  Women do not always seek care for UI, even when it is severe. Besides UI severity and type, consultation is associated with aging, weak social support, conversation about it with close friends and family, and neurologic disorders.
authors.affiliation: Poitiers University Hospital, INSERM CIC802, Poitiers, France; INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, Univ Paris-Sud, Kremlin-Bicêtre, France; Institut National des Etudes Démographiques, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Fritel
authors.forename: Henri
authors.initials: H
authors.lastname: Panjo
authors.forename: Noëlle
authors.initials: N
authors.lastname: Varnoux
authors.forename: Virginie
authors.initials: V
authors.lastname: Ringa
mesh_terms: D000367:Age Factors; D000368:Aged; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000523:psychology* / Q000628:therapy
keywords: care-seeking; female urinary incontinence; longitudinal study